Objective To introduce a novel modified CT severity index based on the assessment of extrapancreatic inflammation and pancreatic necrosis on CT index (EPIPN) and to evaluate its effect in predicting the severity and prognosis of acute pancreatitis. Methods Seventy-seven consecutive patients diagnosed as acute pancreatitis (AP) from August 2006 to December 2007 were retrospectively analyzed. The clinical data included age, sex, cause, the C-reactive protein(CRP) level with in 72 hours of onset of symptom, Ranson signs, the APACHE I1 score, the disappearing time of the abdominal pain, the presence of organ failure, the length of hospital stay, etc. All patients underwent contrast-enhanced multisection CT scan after admission of 48-72 hours. The CT severity index (CTSI) and EPIPN scores were obtained. The severity of pancreatitis for each patient was then categorized as severe if CTSI≥7 or EPIPN>5. The diagnostic value of EPIPN in predicting the severe acute pancreatitis (SAP) was compared with that of CTSI using ROC curve. The correlation of EPIPN or CTSI with clinical coutcome was conducted. Results Of 77 patients, 34 were males and 43 were females with mean age of 51.79 years (age range 22-92 years). The causes of AP were gallstones (63 cases), hyperlipemia (6 cases), alcohol (1 case) and idiopathic (7 cases). Organ system failure was present in 14 (18.2%) of the 77 patients. The area under the ROC curve of CTSI in predicting the SAP was 0.72 (95% CI: 0.59-0.88) with sensitivity of 80.4% and specificity of 55% when CTSI≥7, and that in EPIPN was 0.82 (95% CI: 0.73-0.91) with sensitivity of 91.3% and specificity of 63% when EPIPN >5. EPIPN was well correlated with hospital stay, APACHE Ⅱ score and CRP levels. Conclusions The EPIPN allows accurate estimation of disease severity and prognosis in AP patients. The diagnostic effect of EPIPN for predicting SAP is superior to CTSI. The EPIPN index is-both convenient and practical, and has clinical value.

Objective:To evaluate the utilization of Kanglaite injections in lung cancer patients in 11 hospitals of Zhejiang and analyze the prescription data. Methods: Totally 40-day prescription data of the patients with lung cancer in 11 hospitals of Zhejiang were withdrawn every year from 2009 to 2013. The data in respect of the consumption sum, DDDs, department distribution and medical insurance category of Kanglaite injections were analyzed. Results: The consumption sum of Kanglaite injections used in the patients with lung cancer in 11 hospitals of Zhejiang showed an upward trend year by year, the growth in 2011 and 2012 was the fastest, and the sum in 2012 was 1. 77-fold of that in 2009. The consumption sum proportion of Kanglaite injections in total amount of drug consumption rose after the first drop. The top 3 departments were oncology, radiotherapy and thoracic surgery in the five years. The dosage and DDDs of Kanglaite injections were also in an increase trend year by year, and the growth in 2011 and 2012 was the fastest. Conclusion:The utilization of Kanglaite injections in the patients with lung cancer in Zhejiang area shows a continuous rapid growth momentum, therefore, it is still essential to strengthen the reasonable application in clinics.

Objective To study the protective effects of the intracord transplantation of microgene pSVPoMcat－ genetically－ modified Schwann cells (MSCs)on spinal cord injury (SCI).Method Rats with semi－ division(SD) of the spinal cord was divided into 4 groups.Group S consisted of the rats with SD treated with the transplantation of MSCs, Group B of the rats with SD treated with the transplantation of SCs without genetic modification,Group C of the rats with SD without treatment and Group D was the normal control. 8 hours after operation,the half of the rats of each group were killed and the injured segment of the spinal cord was resected to be examined with atomic absorption spectrophotometry . Another half of the rats of all the groups were examined with neurological function tests to have a combined behavioral score (CBS).Result There was a significant increase of water content and Na＋ and Ca2＋ ions and a decrease of K＋ and Mg 2＋ ions in the injured cord segment of Group C and a statistically significant recovery was observed in Group A. The intracord transplantation of pSVPoMcat genetically modidied SCs improved the neurological outcome of spinal cord injury.Conclusion Our findings indicate that intracord transplantation of pSVPoMcat－ genetically－ modified－ Schwanncells exerts protective effects on the injured segment of the spinal cord through the improvement of the internal ion environment of the spinal cord.

Objective To assess the value of multisection spiral CT perfusion in evaluating severity of acute pancreatitis (AP). Methods Eighty two AP patients, who were admitted to the hospital between August 2006 and January 2008, were enrolled. Multisection dynamic CT (MSCT) perfusion was performed on all patients 48-72 hrs after admission by using a multisection CT scanner (Siemens somatom sensation 64), and 30 healthy subjects were served as controls. The data were processed on a siemens workstation using PCT software package. The parameters including blood folw (BF), blood volume (BV), peak time (TTP) and surface permeability (PS) were measured and compared. Results The values of BF, BV, TTP and PS in AP patients were (110.57±60.04) ml·100 ml-1·min-1, (156.68±65.11) ml/L, (146.58±29.46) 0.1 s, (110.73±62.66) 0.5 ml·100 ml-1·min-1, respectively. The decreased BF and BV were found in AP patients compared with controls (P<0.05). However, there was no significant difference in TTP and PS between two groups (P>0.05). Conclusions The decreased perfusion in AP patients was associated with the severity of the disease. The parameters of BF and BV can be used to predicte the severity of AP.

Objective To investigate the blood perfusion characteristic of acute pancreatitis (AP) using multisection dynamic CT. To detect the changes of the perfusion parameters in patients with AP and assess the value of the perfusion parameters as severity indicators in AP. Methods 120 cases (34 cases of normal pancreas and 86 cases of AP) were examined for pancreatic perfusion from August 2006 to April 2008. The multisection dynamic CT perfusion series was performed by a multisection CT scanner (Siemens somatom Sensation 64) and the perfusion parameters, including BF, BV, TTP, PS, were collected and were compared with APACHE Ⅱ score, Ranson score, CRP, CTSI, time to abdominal pain cessation, length of hospital stay and complication rate for correlation analysis. Results The mean BF, BV, TTP and PS in AP patients were (113.57 ±50.04) ml · 100 mg~(-1) · min~(-1), (146.61 ±45.11) ml/L, (148. 88 ±21. 16) 0.1 s, (119.53± 52.36) 0. 5 ml · 100 ml · min , respectively; when compared with normal control, BF, BV decreased significantly (P<0.05) , while the change of TTP, PS were not statistically significant. Both BF and BV were correlated with APACHE II score, Ranson score, CRP, CTSI (P<0. 05) , as well as the time to abdominal pain cessation, length of hospital stay and complication rate (P < 0. 05). Conclusions Pancreatic vessel perfusion was decreased in AP. Both BF and BV were correlated with APACHE Ⅱ score and Ranson score, CRP, CTSI, and could be used to predict severity of acute pancreatitis.

Objective:To evaluate the efficacy and pharmacoeconomics of rhIL-11(Ⅰ) and rhTPO in the treatment of thrombocy-topenia caused by gemcitabine chemotherapy in lung cancer patients. Methods:A retrospective analysis was used. Totally 58 hospital-ized lung cancer patients who suffered thrombocytopenia caused by gemcitabine chemotherapy and treated with rhIL-11(Ⅰ) or rhTPO from June 2011 to June 2014 were involved in the study, and the efficacy and pharmacoeconomics of rhIL-11(Ⅰ) and rhTPO were e-valuated and compared. Results:The lowest platelet value after the chemotherapy in rhIL-11(Ⅰ) group was higher than that in rhTPO group (P<0. 01), and the platelet decrease time in rhIL-11(Ⅰ) group was shorter than that in rhTPO group (P<0. 01), while the platelet qualified rate of the two groups showed no statistically significant difference (P>0. 05). The results of cost-minimization anal-ysis showed that the average cost of rhIL-11(Ⅰ) group was lower than that of rhTPO group(P<0. 01), furthermore, the average cost of the patients with GP, GC or the other gemcitabine chemotherapy regimens in rhIL-11 (Ⅰ) group was lower than that in rhTPO group. Conclusion:The effect of rhIL-11 (Ⅰ) in the treatment of thrombocytopenia caused by gemcitabine based-chemotherapy in lung cancer patients is not inferior to that of rhTPO, and shows certain advantages in economic cost.

This article expounds on the necessity of the introduction of comparative imaging in bone and joint imaging teaching according to the bone and joint imaging teaching situation and modern medical radiographic features.Meanwhile,it discusses the application of comparative imaging in bone and joint imaging teaching from aspects of teaching method,teaching effect evaluation and prospects of the comparative imaging.

Objective To observe the effect of sinomenine(SINO) on immune function of adjuvant arthritis(AA) rats.Methods SD rats were randomized into normal group,model group,SINO groups(treated with gastric gavage of SINO at the doses of 60,120 and 240 mg/kg respectively),and glucosides of Tripterygium Wilfordii(30 mg/kg) group.Except the normal group,the rats in other groups received subcutaneous injection of the complete Freund's adjuvant 0.1mL into the left hind foot to induce AA.The medication began from 12 days after the modeling and lasted 12 days.The pedal swelling and joint function scores were observed in different time.Radioimmunoassay was used to detect the contents of interleukin-1?(IL-1?) and tumor necrosis factor ?(TNF-?) in synovial cells.Expression of IL-1? and TNF-? mRNA was examined by reverse transcription-polymerase chain reaction(RT-PCR) assay.Results SINO at different concentrations decreased the pedal swelling and arthritis scores to various degrees,inhibited the production of IL-1? and TNF-? in the synovial cells,reduced the expression of IL-1? and TNF-? mRNA,and recovered the normal histological features of synovial cells in AA rats.Conclusion The therapeutic mechanism of SINO for rheumatoid arthritis may be related with the inhibition of secretion of inflammatory mediators in synovial cells,and with the recovery of histological features of synovial cells.

Objective To investigate the effect of Cordyceps Sinensis and Mycelium of Cultured Sinensis on acute injury in this test and expression of CYP450. Methods Mice received a single dose of 0. 1% CCl_4 i. p, after CCl_4 intoxication,mice received Cordyceps Sincnsis and Mycelium of Cultured Sinensis (100mg/ml) 3 times per six hour,then the mice sacrificed at 6h,12h,24h,the levels of aminotransferase (ALT) and glutathione (GSH) in ser-um,CYP45 content in hepatic microsomal activity in fiver homogenate were measured. Results Mice given Cordyceps Sinensis and Mycelium of Cultured Sinensis supplement had less elevation of serum ALT concentration, Cordyceps Sinensis and Mycelium of Cultured Sinensis administration restored the reduction of hepatic microsomal P450 protein content as well as inducing an increase in hepatic GSH concentration. Additionally, Cordyceps Sinensis and Mycelium of Cultured Sincnsis treatment inhibited the elevation of hepatic CYP450 protein after CCl_4 intoxication. Condusion The protect effect of Cordyceps Sinensis and Mycelium of Cultured Sinensis may be due to its abilitity to increase CYP450 content which decreased in CCl_4-induced liver in combination with increasing the activities of antioxidant en-zyme.

Objective:This study aimed to clarify the correlation of SPRY4-IT1 expression with the clinicopathological character-istics and prognosis of patients with esophageal squamous cell carcinoma (ESCC), as well as the role of SPRY4-IT1 in promoting ES-CC cell growth. Methods:Quantitative real-time polymerase chain reaction for SPRY4-IT1 expression was performed on 50 paired can-cerous and adjacent non-cancerous esophageal specimens. Small interfering RNA was used to suppress SPRY4-IT1 expression to fur-ther explore its role in tumor progression. Cell viability was tested in vitro by MTT assay (OD=490 nm), and cell apoptosis and cell cy-cle were investigated by flow cytometry. Results:We found markedly elevated SPRY4-IT1 expression in cancerous tissues compared with adjacent non-cancerous tissues (90%, P<0.01). Relative SPRY4-IT1 expression levels were correlated with some clinicopathologi-cal characteristics, such as tumor size (χ2=5.333, P=0.021), elevated TNM (2009) stage classi fi cation (χ2=5.556, P=0.018), and de-creased overall survival rates (χ2=5.296, P=0.021). SPRY4-IT1 expression level was not correlated with patient age, gender, smoking status, or alcohol consumption (all P>0.05). Further experiments showed that SPRY4-IT1 expression levels were significantly higher in three ESCC cell lines than in the normal human esophageal epithelial cell line Het-1A. In vitro assays of the ESCC cell line KYSE30 demonstrated that knockdown of SPRY4-IT1 expression by small interfering RNA reduced cell growth, mediated cell cycle arrest at the G0-G1 phase, and promoted cell apoptosis (all P<0.01). Conclusion:SPRY4-IT1 was overexpressed in ESCC tissues and ESCC cell lines and promoted the growth of ESCC cells. The dysregulated expression of long non-coding RNA SPRY4-IT1 may play an important role in the process of ESCC development and may be developed as a useful biomarker for the diagnosis and prognosis of ESCC.